Monday, January 01, 2018

Future Fit in the News Again.

I was much taken by the irony of the front page of today’s Shropshire Star. Headline is “NHS boss in pledge to end farce”. Chief Officer of Telford and Wrekin Clinical Commissioning Group (CCG) is quoted “Time for talking is over”. Oh what irony! My sense is that there has been no-one who has contributed more to the ‘farce’ that the man quoted. Let’s recap, for those who have not been following the farce - and try to stick with the facts.
We have known for decades that the Shropshire NHS is not sustainable in the long run without reform. The catchment population (Shropshire and part of Mid Wales, including most of Montgomeryshire) will not sustain two District General Hospitals. The position had been complicated by a Chief Executive of the Trust which runs both hospitals, who decided to spend roughly £30 million on a new Women’s and Children’s Hospital in Telford, when anyone with an iota of strategic thinking capability would have known it should have been built at Shrewsbury. Unfortunately, Mr Adam Cairns did not have a listening gene. This development simply did not deal with the basic problem, and thankfully, Mr Cairns moved on.
It was 2013 when it was decided to face up to the long term  unsustainability issue. The two CCGs representing Shropshire, Telford and Wrekin agreed to establish a Future Fit Programme Board, and said it was setting aside £1.145 million to redesign the service. At the time when the decision about the Women’s and Children’s Hospital decision was taken, the leadership of the Powys Local Health Board just ‘sat on their hands’. Deeply disappointing to me. In 2013, Powys Health Board were enthusiastically ‘onside’ though. Made a difference.
Initially, I favoured a new Emergency Centre on a green field site between the two existing hospitals to replace the two A&E Depts, but that was fairly quickly ruled out for cost reasons. Around £600 million was the rumoured figure. The delays and refusal to face reality continued and the cost of the Future Fit process increased hugely. It was end of 2016 when the Future Fit Programme Board finally put forward its recommendation that Emergency Care should be based at Shrewsbury, and Planned Care should be at Telford’s Princess Royal Hospital. This recommendation had to be approved by the two CCGs covering Shropshire. Shockingly, on Dec 12th 2016, after the expenditure of around £4 million over 3 years, the 2 CCGs failed to reach a decision.
In July 2017, the Future Fit Programme Board (made up of both CCGs plus independent members appointed by the Secretary of State plus reps of Powys Health Board reaffirmed (unanimously) that the Emergency Centre should be at Royal Shrewsbury and Planned Care Centre at Telford’s Princess Royal - long long overdue. This time the Powys Health Board representatives behaved in a responsible way.
Now we are told that the roughly £200 million needed to fund the reform must be agreed before the statutory 12 weeks public consultation  can begin. It’s certainly the case that the “Time for talking is over”. Hope that’s all clear.

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